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State tackles long-overdue redesign of Medicaid

A team has formed to find ways to reduce the costs and increase the quality in the Medicaid program for the upcoming 2011-12 fiscal year. The Governor's office recently announced this redesign team in conjunction with plans to reform our state budget.

The New York Medicaid system spends more than $53 billion a year to provide health care to more than 4.7 mi llion people in need. It is the largest health insurance program in the state. Our state also maintains the largest Medicaid system-larger than California which has an estimated 17.4 million more residents than the state of New York. One study says New York spends as much as California and Michigan combined. At this rate of growth, Medicaid is unsustainable, as costs are projected to grow.

Restructuring Medicaid is long overdue. My colleagues and I have advocated for Medicaid reform for years. If you were to look at a pie chart of the state budget, you would see that Medicaid comprises the largest piece of that pie by far.

In recent days, we've seen media coverage of the redesign team. Some cite startling facts. The Erie County executive said in one report that 96% of Erie County's 2010 tax levy went to Albany to pay for Medicaid services. This is unaffordable. Counties have been asking for ways to opt out of some of the services they are required by New York State law to provide-non-essential services not mandated by the federal government. Opting out of the non-essential services is critical if we are going to institute any cost savings within the local property tax structure. Again, as I said in last week's column, property tax cuts cannot happen without mandate reform. Medicaid contains many state mandates for counties especially, without giving the counties any room for discussion. I'm pleased that discussion has begun.

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